Prevalence of tracheal collapse in an emphysema cohort as measured with end-expiration CT.

Abstract

RATIONALE AND OBJECTIVES:

To retrospectively investigate the prevalence of tracheal collapse in an emphysema cohort. The occurrence of a large degree of tracheal collapse may have important implications for the clinical management of respiratory symptoms and air trapping in patients with emphysema.

MATERIALS AND METHODS:

Paired full-inspiratory and end-expiratory thin-section volumetric computed tomographic scans were available for 1071 long-term smokers with clinically and physiologically confirmed emphysema. The percentage reduction in the cross-sectional tracheal luminal area from full-inspiration to end-expiration was automatically computed at 2.5-mm intervals along the centerline of the trachea using customized software.

RESULTS:

Maximal tracheal collapse did not follow a normal distribution in the emphysema cohort (P < .0001, skewness/kurtosis tests for normality); the median collapse was 18% (intraquartile range, 11%-30%). Statistically significant differences were found in the distribution of maximal collapse by gender (P < .005, Wilcoxon rank sum test). Overall, 10.5% of men and 17.1% of women showed evidence of tracheomalacia on the basis of the criterion of a reduction of 50% or greater in cross-sectional tracheal luminal area at end-expiration.

CONCLUSION:

This study offers insights into the prevalence of tracheal collapse in a cohort of patients with emphysema; future work is needed to determine the possible relationship between tracheal collapse and air trapping in subjects with emphysema.

• Authors: Robert A Ochs, Iva Petkovska, Hyun J Kim, Fereidoun Abtin, Matthew Brown, Jonathan Goldin
• Journal: Academic radiology (Acad Radiol) Vol. 16 Issue 1 Pg. 46-53 (Jan 2009) ISSN: 1878-4046 [Electronic] United States
• PMID: 19064211 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• California (epidemiology)
• Cohort Studies
• Comorbidity
• Emphysema (diagnostic imaging, epidemiology)
• Female
• Humans
• Male
• Middle Aged
• Prevalence
• Risk Assessment (methods)
• Risk Factors
• Smoking (epidemiology)
• Tomography, X-Ray Computed (methods, statistics & numerical data)
• Tracheal Stenosis (diagnostic imaging, epidemiology)